Can supplements boost longevity?

It seems like every longevity influencer has a supplement, or several, he or she swears by.

Mr Bryan Johnson, founder of the Don’t Die movement, takes fistfuls of pills throughout the day, many of which he now sells.

Mr Gary Brecka, host of The Ultimate Human podcast, promotes powders, tablets, beverages, nasal sprays, skin patches and even injectables on his website.

And countless Instagram and TikTok personalities will assure you that they have never felt or looked better, thanks to their favourite supplements, which they are often paid to promote.

Are any of these magic beans legitimate?

Half a dozen doctors and scientists interviewed for this article pointed out that there are no supplements that have been shown to extend human lifespan in a large clinical trial.

As a result, some said the evidence supporting supplements for longevity was too weak, and the industry too unregulated, to endorse people spending their money on them.

“That whole gemish of things that are hawked and being promoted by influencers and longevity so-called experts or whatever, there’s just no data,” said Dr Eric Topol, founder of the Scripps Research Translational Institute and author of Super Agers.

Others, however, are optimistic about the potential for supplements to improve healthspan – how long a person lives without serious disease – and said that the pills and powders can have a place in supporting people’s health as they get older.

“I look at the whole space as one of opportunity,” said Dr Eric Verdin, president and chief executive of the Buck Institute for Research on Aging. “But one also that’s fraught with dangers for consumers and false promise.”

Supplements promoted for healthy ageing generally fall into two camps: traditional vitamins and more experimental products. Here is a look at each.

Traditional vitamins

Several of the experts said vitamin D, vitamin B12 and omega-3s are the three nutrients they tend to recommend for older adults.

That is in large part because it is not unusual for people to be deficient in them, particularly as they age. Older adults can have difficulty absorbing vitamin B12, and certain medications can exacerbate the problem.

People who live in places without much sunshine may not receive enough vitamin D, and those who do not eat fish regularly may not be getting enough omega-3s.

Observational studies have suggested that having low levels of vitamin D and omega-3s, in particular, seems to raise the risk for several health conditions related to ageing, such as heart disease, cancer and osteoporosis.

Those findings have spurred research to see if supplementing with the nutrients could help prevent those diseases. However, the results from clinical trials have largely been lacklustre.

In two of the most high-profile studies, the 2018 Vital trial conducted in the United States and the 2020 Do-Health trial conducted in Europe, thousands of older adults took a vitamin D or omega-3 supplement, or both, for three to five years.

When looking at the participants as a whole, neither study showed the supplements had any benefit when it came to cancer diagnoses, cardiovascular health, bone fractures or cognition.

The results were a little more promising for the subset of participants who may have had a deficiency in omega-3s.

Specifically, people who ate fewer than 1.5 servings of fish a week did see a reduction in strokes and heart attacks from taking a supplement. There was no difference in the results for people who entered the trials with lower levels of vitamin D.

Consistent with these findings, many clinicians take a nuanced approach when counselling patients about vitamin supplements.

Dr Alison Moore, director of the Stein Institute for Research on Aging and the Center for Healthy Aging at the University of California San Diego, said she will occasionally recommend omega-3s and vitamins D and B12 to her patients if she has reason to believe they have a deficiency. But, she added, “if they have a healthy diet, then I really don’t recommend supplements”.

Recently published follow-up analyses from the Vital and Do-Health trials have added a new layer of intrigue around the supplements, suggesting they may potentially impact aspects of the ageing process itself. Vitamin D was associated with slower telomere shortening, and omega-3s were tied to slower biological ageing.

Dr JoAnn Manson, a professor of medicine at Harvard Medical School who led the Vital trial, speculated that these effects might stem from the supplements’ anti-inflammatory properties. But, she added, it’s “really unclear” how exactly that translates to a longer lifespan.

Experimental supplements

The experimental – and more buzzy – category of longevity supplements includes things like nicotinamide adenine dinucleotide (NAD+), spermidine and urolithin A. Some researchers think they have the potential to improve healthspan and counteract the declines in organ and muscle function that occur with age.

Many of these are molecules that the body already makes for cellular health, and in theory, they may have anti-ageing benefits if their quantities are increased through supplementation.

For example, NAD+ plays an essential role in cellular energy production, and its levels fall with age. Spermidine appears to stimulate autophagy, one way that the body recycles damaged proteins and cell parts; autophagy also declines with age. Urolithin A is produced by gut bacteria and is thought to improve the health of mitochondria – the power plant of the cell.

Testing on rodents and worms, or on human cells in a dish, has shown that these molecules can improve some of the negative effects of ageing and even prolong lifespan. Supplement companies often cite these studies on their websites, and influencers tend to repeat them as evidence that the products work.

Dr Topol called such claims “smoke and mirrors”. There is a big jump between improving the health of a mouse or helping a worm live longer and showing the same benefit in a person.

Indeed, the few small human clinical studies that do exist for these supplements found minimal, if any, improvements in health. NYTIMES